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A Study to Evaluate the Safety and Tolerability of Immunotherapy Combinations in Participants With Advanced Malignancies

Phase 1
Completed
Conditions
Non-small Cell Lung Cancer
Squamous Cell Carcinoma of the Head and Neck
Breast Cancer
Colorectal Cancer
Melanoma
Bladder Cancer
Ovarian Cancer
Endometrial Cancer
Merkel Cell Carcinoma
GastroEsophageal Cancer
Interventions
Registration Number
NCT03629756
Lead Sponsor
Arcus Biosciences, Inc.
Brief Summary

This is a Phase 1, open-label, dose-escalation and dose-expansion study to evaluate the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD) and clinical activity of etrumadenant (AB928) in combination with zimberelimab (AB122) (an anti-PD-1 antibody) in participants with advanced malignancies.

Detailed Description

In the dose-escalation phase, escalating doses of etrumadenant in combination with zimberelimab will be assessed in participants with advanced malignancies. Eligible participants will receive oral administration of etrumadenant as well as IV infusion of zimberelimab. The recommended Phase 2 dose (RP2D) of etrumadenant will be determined upon completion of the dose-escalation phase.

In the dose-expansion phase, etrumadenant at RP2D in combination with zimberelimab may be assessed in participants with advanced clear-cell renal cell carcinoma (RCC) or metastatic castrate-resistant adenocarcinoma of the prostate (mCRPC).

Overall duration of treatment will depend on how well the treatment is tolerated. Treatment may continue until unacceptable toxicity or progressive disease or other reasons specified in the protocol.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  1. Male or female participants ≥ 18 years

  2. Must have at least 1 measurable lesion per RECIST v1.1.

  3. Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.

  4. Must have received standard of care, including potentially curative available therapies or interventions.

  5. Confirm that an archival tissue sample is available and ≤ 6 months old; if not, a new biopsy of a tumor lesion must be obtained. Biopsy must not put participant at undue risk and the procedure must not be more invasive than a core biopsy.

  6. Adequate organ and marrow function

    Dose escalation only:

  7. Pathologically confirmed non-small cell lung cancer, squamous cell carcinoma of the head and neck, renal cell carcinoma, breast cancer, colorectal cancer, melanoma, bladder cancer, ovarian cancer, endometrial cancer, Merkel cell carcinoma, or gastroesophageal cancer that is metastatic, advanced or recurrent with progression for which no alternative or curative therapy exists or standard therapy is not considered appropriate by the participant and treating physician (reason must be documented in medical records).

    Dose expansion only:

  8. Participants with advanced clear-cell RCC or mCRPC.9. Clear-cell RCC participants may have received up to 2 prior lines of therapy, one of which must have included an anti-PD-(L)1 based therapy and must not have progressed within 16 weeks during an anti-PD-(L)1 therapy.

  9. mCRPC participants must have progressed during or following treatment with an androgen synthesis inhibitor, and have also had one prior line of a taxane-containing regimen or the physician and participant consider the taxane-containing regimen to be inappropriate.

  10. mCRPC participants must be naive to any immunotherapy (including but not limited to anti-PD-(L)1 or anti-CTLA-4 antagonists, sipuleucel-T, etc.).

Exclusion Criteria
  1. Use of any live vaccines against infectious diseases (eg, influenza, varicella) within 4 weeks (28 days) of initiation of investigational product.
  2. Underlying medical conditions that, in the Investigator's or Sponsor's opinion, will make the administration of investigational product hazardous (eg, interstitial lung disease, active infections requiring antibiotics, recent hospitalization with unresolved symptoms) or obscure the interpretation of toxicity determination or AEs, or concurrent medical condition requiring the use of immunosuppressive medications or immunosuppressive doses of systemic or absorbable topical corticosteroids.
  3. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
  4. Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the pre-screening or screening visit through 90 days after the last dose of etrumadenant in combination with zimberelimab.
  5. Any active or documented history of autoimmune disease, or history of a syndrome that required systemic steroids or immunosuppressive medications, except for vitiligo or resolved childhood asthma/atopy. Participants with asthma who require intermittent use of bronchodilators (such as albuterol) will not be excluded from this study.
  6. Prior malignancy active within the previous year except for locally curable cancers that have been apparently cured, such as basal or squamous cell skin cancer, superficial bladder cancer or carcinoma in situ of the cervix, breast, or prostate cancer.
  7. Dose escalation: Prior treatment with an anti-PD-L1, anti-PD-1, anti-CTLA-4, or other immune checkpoint inhibitor or agonist as a monotherapy or in combination;
  8. Use of other investigational drugs (drugs not marketed for any indication) within 28 days or at least 5 half-lives (whichever is longer) before investigational product administration.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Dose EscalationZimberelimab3+3 design, including a DLT evaluation period. Etrumadenant RP2D will be determined in this part with escalating doses of oral etrumadenant in combination with a fixed dose of IV zimberelimab.
Dose EscalationEtrumadenant3+3 design, including a DLT evaluation period. Etrumadenant RP2D will be determined in this part with escalating doses of oral etrumadenant in combination with a fixed dose of IV zimberelimab.
Dose Expansion-advanced clear-cell RCCEtrumadenantEtrumadenant at RP2D + zimberelimab
Dose Expansion-advanced clear-cell RCCZimberelimabEtrumadenant at RP2D + zimberelimab
Dose Expansion-mCRPCEtrumadenantEtrumadenant at RP2D + zimberelimab
Dose Expansion-mCRPCZimberelimabEtrumadenant at RP2D + zimberelimab
Primary Outcome Measures
NameTimeMethod
Percentage of participants with Adverse EventsFrom first dose date to 90 days after the last dose (approximately 3 years)

Safety will be assessed by monitoring adverse events and clinically relevant changes in Eastern Cooperative Oncology Group (ECOG) performance status, 12 lead Electrocardiogram (ECG), vital signs, physical examination and clinical laboratory results.

Percentage of participants who experience a Dose Limiting ToxicityFrom first study treatment administration through Day 28
Secondary Outcome Measures
NameTimeMethod
Etrumadenant Peak Serum Concentration: CmaxRecorded at baseline (screening), during the first 4 cycles of treatment (4 months) and 30 and 90 days post last dose (approximately 7 months)
Zimberelimab Peak Serum Concentration: CmaxRecorded at baseline (screening), during the first 4 cycles of treatment (4 months) and 30 and 90 days post last dose (approximately 7 months)
Etrumadenant Time of Peak Concentration: TmaxRecorded at baseline (screening), during the first 4 cycles of treatment (4 months) and 30 and 90 days post last dose (approximately 7 months)
Zimberelimab Time of Peak Concentration: TmaxRecorded at baseline (screening), during the first 4 cycles of treatment (4 months) and 30 and 90 days post last dose (approximately 7 months)
Percentage of participants with anti-drug antibodies to zimberelimabRecorded at baseline (screening), during the first 4 cycles of treatment (4 months), at end of treatment, and 30 and 90 days post last dose (approximately 7 months)
Progression Free Survival (PFS)From start of treatment up to the first occurrence of progressive disease or death from any cause (approximately 1-3 years)

PFS as determined by Investigator according to Prostate Cancer Working Group 3 (PCWG3) for prostate adenocarcinoma and per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 for all other tumor types

Overall Survival (OS)From study start of treatment up to death from any cause (approximately 1-3 years)

OS as determined by the Investigator according to PCWG3 for prostate adenocarcinoma and per RECIST v1.1 for all other tumor types

Duration of Response (DOR)From the date of first occurrence of a documented objective response to first documentation of disease progression or death from any cause, whichever occurs first (approximately 1-3 years)

DOR as determined by the Investigator according to PCWG3 for prostate adenocarcinoma and per RECIST v1.1 for all other tumor types

Percentage of Participants with Disease ControlFrom study enrolment until disease progression or loss of clinical benefit (approximately 1-3 years)

Disease Control (complete response, partial response, or stable disease) for \>6 months as determined by the Investigator per PCWG3 for prostate adenocarcinoma and per RECIST v1.1 for all other tumor types

Percentage of participants with Objective ResponseFrom study enrolment until participant discontinuation, first occurrence of progressive disease, or death from any cause, whichever occurs first (approximately 1-3 years)

Objective Response as determined by Investigator according to PCWG3 for prostate adenocarcinoma and per RECIST v1.1 for all other tumor types

Trial Locations

Locations (15)

Scottsdale Healthcare Hospitals dba HonorHealth

🇺🇸

Scottsdale, Arizona, United States

University of California, Los Angeles

🇺🇸

Los Angeles, California, United States

The Angeles Clinic and Research Institute

🇺🇸

Los Angeles, California, United States

Rocky Mountain Cancer Centers (Midtown)

🇺🇸

Denver, Colorado, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

QUEST Research Institute

🇺🇸

Royal Oak, Michigan, United States

Carolina BioOncology Institute

🇺🇸

Huntersville, North Carolina, United States

Prisma Health

🇺🇸

Greenville, South Carolina, United States

Texas Oncology, P.A. - Fort Worth Cancer Center

🇺🇸

Fort Worth, Texas, United States

Texas Oncology, P.A. - San Antonio Medical Center

🇺🇸

San Antonio, Texas, United States

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Scottsdale Healthcare Hospitals dba HonorHealth
🇺🇸Scottsdale, Arizona, United States

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